Common over-the-counter pain relievers, like ibuprofen, may raise your risk of having a heart attack. That's the finding in a new report in the respected medical journal The Lancet. The review boiled down hundreds of earlier studies that followed more than 350,000 patients. It found that people taking four 200 milligram ibuprofen pills three times a day for a year, a common dosage for arthritis patients, increased their risk of heart attack significantly.

Mayo Clinic cardiovascular specialist Stephen Kopecky, M.D., says it's something doctors have known about for years. Similar concerns lead to the banning of certain brand name Cox-2 inhibitor pain medications in 2004. However, Dr. Kopecky says the lack of lawsuits against generic drug manufacturers has allowed over-the-counter pain relievers to avoid the same scrutiny.

"Some of the drugs that are over-the-counter now, like ibuprofen, actually have a higher risk of causing a heart attack in a patient that takes them than some of the brand name drugs that were taken off the market a few years ago."

The study estimated there would be three additional heart attacks in every 1,000 people because of use of the pain killers. The risk to heart health was also found with one of the most commonly prescribed pain killers worldwide, diclofenac. Dr. Kopecky says many of his patients, not at risk for stomach bleeding, are on a daily low-dose aspirin regimen to reduce their risk of heart attack or stroke.

"Well, I certainly tell them, No. 1, keep taking your aspirin, don’t stop you aspirin. No. 2 is, if you can take Tylenol, or acetaminophen is the generic name, take that. We know those won’t harm your arteries or cause blood clots.”

For muscle aches, Dr. Kopecky says tried and true ice or heat therapies are worth a try before turning to medication. And he suggests those with chronic neck or back pain ask their doctors for stretching and strengthening exercises, which can be surprisingly effective when used regularly.